Individual
BLAKE A NORRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7905 N MEADOWLARK WAY # C&D, COEUR D ALENE, ID 83815-5041
(208) 981-1277
Mailing address
2965 E BURGUNDY TRL, POST FALLS, ID 83854-9814
(208) 981-1277
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/12/2024
Last updated
01/12/2024
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